Doctor Name: | MR. IMRAN SYED NIZAMUDDIN |
NPI Number: | 1588946685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R.PH. |
License Number: | 051.291232 |
Business Practice Address: | 2311 Ogden Ave Aurora, IL - 605047221 |
Business Phone Number: | 6308983431 |
Business Fax Number: | |
Mailing Address: | 3818 White Eagle Dr, NAPERVILLE |
State: | IL |
Postal Code: | 605649706 |
Phone Number: | 6308981283 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2011 |
NPI Last Update Date: | 09/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 051.291232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |